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	We call upon all States to strictly respect International Humanitarian Law by International Committee of the Red Cross (ICRC)   Dec. 2024   ICRC: "We have the chance to improve the lives of millions if all parties respect IHL".   (Speech delivered by Ms. Laetitia Courtois, Permanent Observer and Head of Delegation of the ICRC, to the UN General Assembly debate on strengthening the coordination of humanitarian and disaster relief assistance. Decemeber 2024).   "The world is in turmoil: geopolitical divisions and tensions are mounting, increasing (re)militarization of economies and societies are leading to a growing climate of preparation for wars that extends beyond major powers to those in their orbit.   In parallel, we see new conflicts arising and armed actors multiplying while political settlements for existing conflicts remain elusive. In 2024, over 120 armed conflicts are tearing apart communities affecting millions of people.   In 2024, we recorded no less than 455 armed groups of humanitarian concern. In 2024, more than 210 million people are living in areas under the control of non-state armed groups often remaining cut off from essential services and further deepening their vulnerability.   The proliferation of armed conflicts, coupled with increasingly permissive interpretations of International Humanitarian Law (IHL) continue to have an unacceptable cost, creating immense suffering, extensive loss of life and ever-growing humanitarian needs.   Harmful information poses an additional threat to persons affected by conflict and exposes humanitarian action to significant security and safety risks.   Against the backdrop of this grim reality, the ICRC has three urgent calls:   First, we urgently ask your support to help secure adequate humanitarian space in today’s conflicts. Calls for humanitarian access are too often used as a way for warring parties to evade / deflect from their primary responsibilities to respond to the needs of the population on the territories they control.   Too often, parties to conflict are diverting the attention towards the issue of access of humanitarian assistance as a primary concern – thereby putting the onus on humanitarians rather than on fulfilling their own responsibilities notably towards the population under their control.   We also see a trend to increasingly condition humanitarian access to a negotiated ceasefire / cessation of hostilities. Let’s be clear: humanitarian access should not be blocked until a political agreement is reached or cessation of hostilities are agreed upon. It is an imperative, and a clear obligation.   Even more so when we see how means and methods of warfare have exacerbated the level of destruction and damage. Today, it only takes a few hours to destroy an entire city, but decades to repair or rebuild it.   In the Pact for the Future, the international community committed to protect all civilians in armed conflict and for people affected by armed conflict to receive assistance. We call for these commitments to be put in practice.   Second, the dangerously elastic interpretation of international humanitarian law rules and obligations we are witnessing urgently requires all states to reaffirm their commitment to IHL, in words and in deeds. It is not enough to quote IHL; it is now more necessary than ever to uphold, promote and defend an IHL that is interpreted in a way that allows it to serve its purpose.   Warring parties and their allies must not shy away from this moral, ethical and legal necessity, or hide behind exceptionalism. IHL is not a justification for destruction and killings, it’s the last lifeline of humanity in the chaos of war.   It is the ICRC’s conviction that this trend can and must be reversed. We know from working on frontlines that when IHL is respected, lives are saved, and human dignity preserved.   Compliance with the rules of war is possible, if there is political will to put into practice what is outlined in the Geneva Conventions. In many conflicts, warring parties have chosen to respect IHL, have shown that respect for IHL is possible, that military and civilian victims of war can be protected. While these instances of respect are far too few, they are significant, and they can inspire and guide us in persevering in our work towards better respect for IHL by all parties in all conflicts.   Firmly convinced of the urgent need to do better, the ICRC, along with 6 States, launched the Global IHL initiative to galvanize States’ commitment towards IHL. We call on all States to join this initiative.   Third, digital threats to civilians and new technologies must be adequately addressed. In situations of armed conflict, access to digital technology can save lives. However, the digitalization of armed conflict also brings new threats for civilians. The malicious use of digital technologies and the spreading of harmful information is increasingly destabilizing societies and aggravating vulnerabilities among the civilian population.   Digital technologies permeate our lives, and cyber and information operations are no longer abstract or "only online". We call on parties to armed conflict to comply with their legal obligations, and assess, prevent, or mitigate the harm that their operations may cause to civilians, civilian infrastructure and other protected persons.   New and emerging technologies are also changing the way armed conflicts are fought making them more complex. The use of cyber operations in conjunction with traditional weapons, and the increasing use of artificial intelligence in weapons systems and decision-making, feature prominently in discussions on the evolution of warfare.   Together with the secretary-general of the United Nations, the ICRC has called on states to urgently negotiate and conclude by 2026 a treaty regulating autonomous weapon systems. We repeat that call here.   By better securing humanitarian space, by properly interpreting IHL, and by addressing new threats in armed conflict, we have the chance to improve the lives of millions".   * 28 Jan 2025: Informal interactive dialogue, of UN General Assembly, 79th session; Preserving human dignity in armed conflict: promoting compliance with international humanitarian law - UN WebTV: http://webtv.un.org/en/asset/k12/k12ajz5mw5   Aug. 2024   (Speech by Balthasar Staehelin, Head of the ICRC Regional Delegation for East Asia marking the 75th Anniversary of the Geneva Conventions at an event held at the Swiss Embassy in Beijing, on August 12, 2024).   "Today we mark the 75th anniversary of the four Geneva Conventions of 1949. Exactly 75 years ago, on 12 August 1949, the four Geneva Conventions were adopted, marking a momentous normative step forward in the quest to uphold humanity and human dignity in war.   Today, the universally ratified four Geneva Conventions, together with their additional protocols, have become the cornerstone of international humanitarian law. The fact that all States freely and voluntarily accept to be bound by the four Geneva Conventions demonstrates the universal values embodied by international humanitarian law.   In the past 75 years, the four Geneva Conventions have been fundamental in protecting persons affected by armed conflict, and international humanitarian law remains as relevant today for contemporary armed conflicts, as it was 75 years ago.   It is important to note that international humanitarian law has been born and developed long before the four Geneva Conventions of 1949. IHL is based on humanitarian principles which are deeply rooted in many of the world’s cultures and traditions. International humanitarian law both complements and reinforces these legal traditions, civilizations, and cultures, and is therefore a common heritage of all humanity, reflecting a global consensus that all wars have limits.   The focus on protection of people through rules that uphold basic human values even during the darkest moments, make the Geneva Conventions one of the most important documents in history. International humanitarian law is essential in preventing some of armed conflicts’ worst consequences. It aims to protect persons who are not, or are no longer, taking part in hostilities and to limit the means and methods of warfare to maintain some humanity in armed conflicts, saving lives and reducing suffering.   Today, 75 years after the adoption of the four Geneva Conventions, international humanitarian law and the need for it to be fully respected is more important than ever. Currently, there are over 120 ongoing armed conflicts none of which were inevitable. With every conflict, the ICRC sees first-hand the scale of human tragedy. When IHL is not respected the humanitarian consequences of conflict are exacerbated.   Non-compliance with IHL remains an alarming problem. Even when parties claim compliance, overly permissive interpretations of IHL hinder its effectiveness. All too often, we see the sanctity of hospitals disregarded, ambulances attacked, civilians killed and displaced in great numbers, prisoners and detainees ill-treated, humanitarian access impeded and humanitarian workers, including colleagues from our Red Cross and Red Crescent Movement, injured and killed when carrying out their purely humanitarian mission.   And this not only so in the armed conflicts that are under the spotlight of the world’s attention, but in many forgotten protracted wars that have caused unspeakable human suffering for decades.   We observe that the main cause of suffering during armed conflicts remains the failure to implement existing norms, rather than a lack of rules or their inadequacy.   These trends must be reversed! The erosion of the protective force of IHL can and must be urgently stopped by making IHL a political priority – everywhere, as a common denominator of humanity in a divided world.   Experience has shown that in order for international humanitarian law to prevent or alleviate the immense suffering caused by armed conflicts, it must be faithfully and effectively implemented in practice. Therefore, international humanitarian law cannot be merely the law on paper, it must be the law in action.   This requires building an environment conducive to the respect of international humanitarian law and to foster a universal culture of compliance with international humanitarian law.   States must effectively implement international humanitarian law at the domestic level, prevent violations of the law, and punish the perpetrators when violations do occur. States must not politicise or instrumentalise IHL or the development of IHL but instead champion respect and compliance with IHL. Non-state armed groups, too, must fully respect their obligations under IHL.   As states aspire for lasting peace and security, it is important to remember that compliance with IHL fosters an environment conducive to peace that has the power to break the never-ending cycles of violence. By prohibiting weapons that cause superfluous injuries and unnecessary suffering States take one step closer to peace, by ensuring detainees and internees are treated humanely, States preserve their dignity and reduce the risk of further violence fuelled by revenge.   When States return or repatriate human remains to their families this facilitates the closure of grief and healing. Cruelty and inhumanity beget violence and instability. Compliance with IHL on the other hand can pave a road back to peace and stability.   The ICRC having worked in war zones for 161 years, has seen what armed conflicts and other situations of violence do to humanity. We see its horrific toll on combatants and civilians every day. We help people who have lost their families or their homes. We treat gruesome injuries. We witness the horrors and devastating impact of torture and rape. We see what war does to children and childhood. We see this violence inflicted by state and non-state actors, by GPS-guided munitions and home-made bombs, all over the world.   The average time that the ICRC has been present in its ten largest operations is more than 42 years. With every new armed conflict we confront, we know that chances are high it will drag on for years to affect a generation or generations– hindering possibilities for development and draining resources.   States are the very architects of international humanitarian law and they must demonstrate the political will and tenacity to promote and enforce it.   You have all entrusted ICRC with a sacred mandate under the Geneva Conventions, we ask you to support us in fulfilling in faithfully. As an organization mandated to protect and assist victims of armed conflict, the ICRC feels a responsibility to urge states to comply with IHL.   However, the ICRC cannot enforce IHL on unwilling States. We call upon all States to strictly respect and ensure respect for IHL. We need your powerful voices to echo support for IHL in all fora".   http://www.icrc.org/en/document/icrc-president-spoljaric-destruction-despair-should-not-let-us-forget-wars-have-limits http://www.icrc.org/en/unga79-50th-session-humanitarian-relief-assistance http://www.icrc.org/en/document/global-and-collective-failure-to-protect-civilians-in-armed-conflict http://www.ipinst.org/2024/09/ipi-president-and-icrc-president-discuss-the-limitations-on-war-and-respect-for-the-geneva-convention http://www.icrc.org/en/statement/icrc-president-mirjana-spoljaric-international-humanitarian-law-was-created-move-beyond-division http://www.icrc.org/en/statement/geneva-conventions-75th-anniversary-reaffirm-commitment-ihl-and-make-it-political http://www.icrc.org/en/news-release/icrc-president-mirjana-spoljaric-human-life-is-human-life http://www.icrc.org/en/statement/un-idenw http://www.icrc.org/en/geneva-conventions-and-law http://www.icrc.org/en/news-release/arms-trade-treaty-must-be-faithfully-implemented-prevent-serious-violations   http://www.icrc.org/en/document/global-and-collective-failure-to-protect-civilians-in-armed-conflict http://blogs.icrc.org/law-and-policy/2024/04/22/protecting-civilians-in-conflict-the-urgency-of-implementing-the-political-declaration-on-explosive-weapons-in-populated-areas/ http://reliefweb.int/report/world/2024-statement-members-ngo-working-group-protection-civilians http://civiliansinconflict.org/press-releases/civic-launches-first-protection-of-civilians-trends-report-and-civilian-protection-index/ http://www.crisisgroup.org/africa-sudan/humanitarian-diplomacy-negotiating-aid-access-turbulent-world http://odi.org/en/events/hpg-annual-event-2024/ http://odi.org/en/insights/think-change-episode-60-sudan-war-whats-the-untold-story/ http://www.acaps.org/en/countries   http://www.unicef.org/press-releases/meaningful-action-prevent-use-explosive-weapons-populated-areas-could-almost-halve http://www.icrc.org/en/what-we-do/war-in-cities http://www.icrc.org/en/document/civilians-protected-against-explosive-weapons http://www.icrc.org/en/explosive-weapons-populated-areas http://www.icrc.org/en/document/addressing-indirect-effects-explosive-weapons http://www.icrc.org/en/publication/i-saw-my-city-die-voices-front-lines-urban-conflict-iraq-syria-and-yemen http://international-review.icrc.org/reviews/irrc-no-901-war-cities   http://www.icrc.org/en/war-and-law/protected-persons/civilians http://hi.org/en/a-political-declaration-against-the-use-of-explosive-weapons-in-populated-areas http://civiliansinconflict.org/press-releases/ewipa-2022-statement/ http://civiliansinconflict.org/blog/ewipa-consultations/ http://www.inew.org/press-release-use-of-heavy-explosive-weapons-killing-civilians-in-towns-and-cities-must-be-prevented/ http://reliefweb.int/report/world/political-declaration-strengthening-protection-civilians-humanitarian-consequences-arising-use-explosive-weapons-populated-areas-final-rev-enarruzh Visit the related web page
	International community must end impunity for violence against Healthcare in Conflict by WHO, Safeguarding Health Coalition, MSF, agencies   Aug. 2024   Attacks on health facilities and staff must never become the norm, says Dr Tedros Adhanom Ghebreyesus - Director-General of the World Health Organization (WHO).   The violent upheaval tearing Khartoum apart has forced many Sudanese people to flee for safety. The war’s impact on the capital’s healthcare system has made it even more urgent for many families to leave. Attacks on medical facilities in Khartoum in 2023 led to a shortage of drugs throughout the capital, which meant that many chronically ill Sudanese could no longer find the medicines they needed.   This is the reality for millions in vital need of healthcare not just in Sudan but elsewhere in the world as well.   In Gaza, multiple attacks on hospitals have killed and injured hundreds, including health workers and displaced people seeking refuge in what were thought to be safe havens. In the Democratic Republic of the Congo (DRC) city of Goma, doctors and nurses have been murdered while trying to care for displaced people.   In Ukraine, the Okhmatdyt Children’s Hospital was targeted in an air raid, killing one doctor and one hospital worker and injuring 16 people, including seven children. In Pakistan, a bomb killed police officers deployed to protect polio vaccination workers.   As the director-general of the World Health Organization (WHO), I have repeatedly condemned such attacks and called for the protection and respect of health workers in humanitarian settings and beyond.   Yet, such calls, and those of our humanitarian partners in the field and around the world, have gone unheard, despite health facilities, their staff, patients and other civilians being protected under international law during conflicts.   In 2023 alone, WHO recorded 1,520 attacks on healthcare, so far this year, more than 700 attacks have taken place. Dire as these numbers are, they likely underestimate the true scale of the problem.   In Gaza, like in Ukraine, Sudan, the DRC, Haiti and beyond, those who fall leave behind grieving families and communities. Parties to conflicts are failing humanitarian and health workers and the people they serve.   Even in responding to clear threats to public health, such as the COVID-19 pandemic and the Ebola outbreak in the DRC, humanitarian and health workers faced fatal attacks, physical threats and psychological intimidation on an unprecedented scale.   Beyond the legal implications, attacks on health interfere with the work of health workers, the distribution of health supplies, and the essential services of health facilities, like vaccinations, prenatal care, and treatment for chronic diseases, leading to preventable deaths and increased suffering.   Even a single attack on the only hospital serving a population can have devastating, long-lasting consequences on healthcare delivery for entire communities in the immediate term, and for years to come. Health facilities provide more than care – in many communities, they offer refuge and contribute to collective welfare.   The WHO Constitution states, “The health of all peoples is fundamental to the attainment of peace and security and is dependent on the fullest co-operation of individuals and States.”   WHO knows all too well the immense value of our colleagues and the pain felt when they are lost needlessly to armed violence. Their dedication is a testament to the impact humanitarian action can have on millions of lives.   By safeguarding health workers we uphold the principles of compassion and solidarity and reaffirm our commitment to a more humane world.   http://www.who.int/activities/stopping-attacks-on-health-care http://www.unfpa.org/news/health-and-humanitarian-workers-face-record-violence-here-are-5-reasons-world-must-take-action http://insecurityinsight.org/wp-content/uploads/2024/07/The-Effects-on-Health-Care-of-the-Use-of-Explosive-Weapons-July-2024.pdf http://www.globalr2p.org/resources/resolution-2286-protection-of-civilians-s-res-2286/   Aug. 2024   Threats to international humanitarian law in Ukraine and Gaza, by Leonard Rubenstein.   Almost a decade ago, a book of essays about the development of, and lack of respect for, international humanitarian law (IHL) in the second half of the twentieth century appeared under the title Do the Geneva Conventions Matter?. The question seems even more relevant now, as, in the first quarter of the twenty-first century, war has been characterized by persistent and vicious assaults on humanitarians, health workers, infrastructure and civilians in general.   Some State militaries and non-State armed groups have demonstrated open contempt for the law’s values and specific rules in wars in the Democratic Republic of the Congo, Gaza, Myanmar, Sudan, Tigray (Ethiopia), Ukraine and in less-reported conflicts around the globe. The Safeguarding Health in Conflict Coalition reported more than 2,500 attacks on healthcare in conflicts in 2023, the highest it has ever reported in its decade of reporting. The atrophy of commitment to IHL is evident too among States, most recently Israel, that celebrate their fealty to it but interpret its obligations so narrowly that they drain it of protective value and justify attacks that result in mass killing and wounding of civilians and destruction of health systems.   Russia’s total war   Russia invaded Ukraine in 2022 on the flimsiest of pretexts, breaching its obligations under the UN (United Nations) Charter not to use force against the territorial integrity or political independence of any other State. Russia’s conduct of the war has been characterized by brutal attacks on hospitals, apartment blocks, train stations and shopping malls, kidnapping and deportation of children, slaughter of civilians, and blockage of aid and evacuation. A consortium of international and national non-governmental organisations (NGOs) documented more than 1,500 attacks on healthcare infrastructure since the beginning of the war, including damage or destruction to more than 770 hospitals and clinics. More than 200 health workers have been killed. A joint report by the World Bank and the UN Development Programme assessed that in the first year, Russia’s attacks on the power grid cut Ukraine’s generating capacity by more than half. When questioned about this conduct, President Vladimir Putin has never sought to justify it under the law.   Analysts generally agree that Russia commits atrocities as part of a military strategy to suppress and deter resistance, demoralise the population and break its will to resist, and exercise psychological pressure on the government. Julia Friedrich and Niklas Masuhr point out that Putin decorated the unit that committed massacres in Bucha. And as Mark Kramer of Harvard’s Davis Center for Russian and Eurasia explains, while Russia has adopted the Geneva Conventions and Protocols and incorporated them into domestic law, it has never integrated them into its military doctrine, training and command. On the contrary, he writes, “contempt for the law is built into Russian military ethos.”   Russia is hardly alone. The Assad regime in Syria launched hundreds of chemical attacks on civilians and, along with Russia, attacked hospitals more than 600 times, while also criminalising the provision of healthcare to anyone in an opposition-controlled area. It never attempted to defend its actions under the Geneva Conventions, only issuing preposterous denials, seeking to discredit the messenger or labelling health workers as supporters of terrorism. The overwhelming evidence is that it attacked civilians and hospitals as a strategy to displace populations and undermine support for opposition forces. In the war in Gaza, Hamas’s massacres of civilians, hostage-taking, indiscriminate rocket fire, sexual violence and embedding fighters within civilian structures convey total disdain for the law.   Russia has paid little price for its atrocities. The International Criminal Court (ICC) has assumed jurisdiction of crimes against humanity committed in the war in Ukraine and indicted Putin and others for abduction of children. It remains to be seen whether it will hold him and Russian commanders to account for their attacks on healthcare.   Israel’s manipulation of international law   By mid-August 2024, Israel had, according to Gaza’s Ministry of Health, killed more than 40,000 Palestinians in Gaza, a figure that includes both combatants and civilians.   Assuming Israel’s claim that its forces have killed 14,000 Hamas fighters is accurate, 60% of the killings were civilian. More than 100,000 people have suffered traumatic injuries. Up to 24 July, the World Health Organization (WHO) reported more than 500 attacks on healthcare infrastructure in Gaza with almost 750 killed and almost 1,000 people injured, many of whom were displaced and sheltering in hospitals. That same month, the number of hospital beds available had declined from 3,500 before the war to 1,400, and of those, only 800 were in fixed hospitals; the rest were in field hospitals with limited capacity. Still in July 2024, more than 10,000 individuals needed urgent medical evacuation. The destruction of housing, sanitation and water infrastructure has led to catastrophic increases in infectious diseases, including more than half a million cases of diarrhoea and a polio outbreak.   By mid-2024, more than 250 aid workers had been killed and more than 350 attacks had been carried out on humanitarian installations and convoys. The Global Education Cluster reported that schools, many of which had been converted to shelters for displaced people, had been directly hit. Sixty-five of them were totally destroyed and another forty-three half-destroyed. A deconfliction system for a humanitarian response has not so much broken down as never been put in place.   Despite the massive death and destruction, Israel has, from the start of the war, asserted that it is committed to compliance with the law on protection of civilians and healthcare. Prime Minister Benjamin Netanyahu has repeatedly claimed that Israel has “the most moral army in the world”. In a speech to the US Congress in July 2024, he argued that Israel “implemented more precautions to prevent civilian harm than any military in history and beyond what international law requires”. People who questioned Israel’s conduct, he said, including judges, are liars who issue “blood libels against the Jewish state”.   Apart from Netanyahu’s tendentious political posturing, Israel’s Ministry of Foreign Affairs issued a brief on how the laws of war apply to the conflict in Gaza. The Ministry reasserted that, while Israel has not ratified the 1977 Additional Protocols to the Geneva Conventions that require adherence to duties of distinction, precaution and proportionality in attack, Israels abides by them under customary international humanitarian law. The brief also argues that Israel trains its forces in the law, provides commanders with legal advice on targeting and investigates allegations of wrongdoing. In addition, the Israeli Supreme Court has jurisdiction to adjudicate on issues arising under the law of war.   Israel, however, has adopted an interpretation of obligations of precautions and proportionality contrary to the language and purpose of the Protocols that permit it enormous leeway to inflict grievous harm on Palestinian women, children and other civilians, on humanitarian workers, and on healthcare facilities and personnel. If adopted globally, its view would drain the law of its protective function.   Evading requirement of precautions   Additional Protocol 1 requires that parties to a conflict take “constant care” to spare the civilian population, including to “take all feasible precautions in the choice of means and methods of attack with a view to avoiding, and in any event to minimizing, incidental loss of civilian life, injury to civilians and damage to civilian objects”. Minimizing civilian harm in a situation of high population density and where Hamas is embedded in civilian structures is challenging, but as the International Committee of the Red Cross (ICRC) Commentaries to the Protocols explain, the requirement is especially critical in fighting in dense urban areas. In addition to the rule of precaution, Additional Protocol 1 includes a separate duty to provide, when feasible, effective advance warning of attacks that may affect the civilian population. In the case of hospitals misused for military purposes, warnings must also include a reasonable time to cease misuse.   The Ministry of Foreign Affairs brief, however, lists precautions only as warnings, calls for evacuation and choosing weapons and munitions that can minimise civilian harm. It makes no reference to precautions in means and methods, nor is there evidence of their use.   Moreover, from the start of the war and for months on end, Israel treated offering warnings and evacuation orders as sufficient to fulfil the duty to take all feasible precautions in attacks. Israel entirely ignored the requirements of employing “means and methods” of warfare to minimise civilian harm. In an attack on 31 October 2023 that dropped two 2,000-pound bombs on the crowded Jabalia refugee camp, killing dozens of Palestinians, the Israeli Defense Forces (IDF) spokesperson cited no precautions, just warnings, and blamed Hamas and the victims for the carnage. He said: “We warned civilians two weeks ago to evacuate that specific area because there was going to be major conflict operations, they should’ve heeded the warning and left”. He added that civilians were paying the price for the atrocities of Hamas. The refrain became common in bombing, shelling and missile strikes on civilian structures in Gaza City, Khan Yunis and Rafah.   Israel also engaged in deflection, treating Hamas’s existential threat to Israel and presence in civilian structures as a legitimate reason for inflicting massive civilian harm. But precautions are required even when a civilian structure becomes a target because of its military use.   After a missile attack on an ambulance parked at Al-Shifa Hospital that caused dozens of casualties, the IDF claimed the presence of Hamas fighters in the vehicle without mentioning any steps to minimise harm to medics, patients and bystanders. In the brutal hospital incursion into Nasser Hospital in February 2024, the IDF took no serious efforts to save the lives of the severely wounded and sick patients there and obstructed the WHO’s efforts to evacuate them for three days. And in the infamous attack on three vehicles in a World Central Kitchen convoy, the IDF’s investigation cited mistaken beliefs by frontline troops that Hamas militants were present, not any precautions (or absence of them) to avoid harming aid workers if they had been.   As a result of international pressure, in 2024 Israel announced it would use more precise weapons in Gaza and support their use through better intelligence and aerial surveillance in targeting. But precision weapons are not precautions when the target is known to have many civilians present and that these latter will inevitably suffer grievous harm. In the attack on the Al-Tabaeen School in the summer of 2024, three precision weapons struck a prayer hall where Israel claimed Hamas fighters were present, resulting in a hundred people being killed, according to Gaza’s Civil Defence.   The IDF’s citation of use of precision weapons became a mantra disconnected from true precautions. After a strike on the courtyard of Al-Aqsa Martyr’s Hospital, where displaced people had sought refuge, killed four people and wounded others, a military spokesperson was quoted by the New York Times as saying: “Numerous steps were taken to mitigate the risk of harming civilians, including the use of precise munitions and aerial surveillance.” The Times noted that the statement “echo[ed] words often employed by the military after airstrikes in Gaza”.   The IDF’s failure to take required precautions to reduce harm to civilians in military operations appears linked to apparent indifference to other obligations under the Geneva Conventions. These include respecting and protecting healthcare workers unless they commit, outside their humanitarian function, acts that harm the enemy, ensuring the availability of the necessities of life including food, shelter, medicine and water, and eschewing torture and cruel, inhuman or degrading treatment. In hospital incursions and other encounters with Palestinian health workers, the IDF has detained more than 260 healthcare workers without charge, and more than thirty have reportedly been tortured.   Proportionality inside out   Israel’s approach to proportionality similarly drains the obligation of its purpose. The rule prohibits attacks that are “expected to cause incidental loss of civilian life, injury to civilians, damage to civilian objects, or a combination thereof, which would be excessive in relation to the concrete and direct military advantage anticipated”. The rule can be difficult to apply, but it remains central to avoiding massive harm and wilful breaches can be prosecuted as war crimes.   As emphasized in the ICRC commentary to Protocol 1, the military advantage in the proportionality calculus relates to the particular attack, not the strategic objective of the war. It must be direct and concrete, not long-term. Otherwise, any civilian harm could easily be considered outweighed by the enormous advantage of moving toward achievement of a strategic objective and render the proportionality rule meaningless. But that has been Israel’s approach in Gaza, citing its strategic goal is the total elimination of Hamas and all its components. As a result, it considers that the killing of Hamas militants or the destruction of any command centre is a step towards achieving its strategic goal that outweighs civilian harm, no matter how great.   Colonel (res.) Pnina Sharvit Baruch, a former director of the IDF branch that advises commanders on the law, repeatedly argued for this theory in public appearances. She said that the strategic goal of eliminating Hamas’s existential threat, and every part of its infrastructure, is “so heavy” and has “such weight” that extensive civilian causalities in a particular attack will not be disproportionate. IDF’s justification of particular attacks either cites the strategic goal of eliminating Hamas or ignores proportionality altogether. In addressing the Al-Tabaeen School attack, Israel’s representative told the Security Council: “We neutralised dozens of vicious terrorists who used the school for their evil goals, in direct violation of international law”, as though no discussion of proportionality was required.   Mark Lattimer, a leading expert on civilian protection in war, wrote that Israel’s approach to proportionality suggests that “Israel’s commitment to that protection is now seriously in doubt”.   Acquiescence in the corrosion of international humanitarian laws   The international community, while endlessly affirming the importance of international humanitarian law, has largely acquiesced in diminishing its force. In particular, it has abdicated responsibility for accountability for both Russia’s blatant crimes committed and Israel’s permissive interpretations of its law that rationalise harm to civilians. The international criminal tribunals established since the 1990s have had the power to prosecute attacks on aid workers and healthcare facilities in cases within their jurisdiction. But since the creation of international criminal tribunals in the 1990s, no international prosecution has focused on attacks on healthcare infrastructure and their staff, no matter how open and vicious. Nor have there been prosecutions under principles of universal jurisdiction.   The ICC prosecutor is reportedly investigating crimes beyond those already charged in Ukraine and Gaza. But it remains uncertain whether he will bring charges related to attacks on healthcare, aid workers and displaced people or have global credibility if he does. Furious condemnations of initial charges against Israeli leaders by the United States may well contribute to undermining the very legitimacy of the ICC and reinforce claims that its work elsewhere, including for crimes in Ukraine, is politically motivated. Even less politically fraught steps, including Israel’s destructive interpretation of the law, have been absent.   Powerful States have reinforced impunity for these crimes by their arms transfer policies. The Arms Trade Treaty and domestic legislation in many countries prohibit arms transfers to State armed forces and non-State armed groups (or, in some cases, units of them) that violate international humanitarian law. The United States, the largest supplier of arms to Israel, has such laws, including one that requires a report to Congress whether representations by a recipient of arms that they are not used to breach IHL are reliable and credible.   In May 2024, the US Secretary of State issued a report to Congress that included addressing the war in Gaza. The State Department noted “instances” where “it is reasonable to assess” that since 7 October, Israeli security forces employed US arms in a manner “inconsistent with its IHL obligations or with established best practices for mitigating civilian harm”. It nevertheless asserted that “The IDF has undertaken steps to implement IHL obligations for the protection of civilians in the current conflict, including the requirements related to distinction, proportionality, and precautions in offensive operations”, even as it acknowledged that the US “lacks full visibility of Israel’s application of these principles.   The report neither explained how it could accept Israel’s representations without adequate information nor addressed Israel’s cramped view of these principles. Similarly, it cited Israel’s assertion that it took steps to mitigate civilian harm without assessing them, noting only that the results on the ground “raised substantial questions whether the IDF is using them effectively in all cases”. It did not address the patterns of attacks and the credibility of Israel’s asserted justifications for them.   The report’s lack of the analysis required and its repeated use of fudge words and phrases such as “instances” and “in all cases” not only authorised continued arms sales to Israel but constitute an invitation to belligerents and their arms dealers elsewhere to ignore the law.   On 2 September 2024, the UK Labour government Foreign Secretary David Lammy suspended thirty arms exports licenses to Israel for weapons he said pose “a clear risk that they might be used to commit or facilitate a serious violation of international humanitarian law”. It was an important but partial step, both regarding the 90% of export licenses not covered and the absence of any discussion of Israel’s view of the law.   Conclusion   One could ask where there is a moral difference between strategically killing civilians, as Russia has, and Israel rationalising its indifference to causing their deaths through bad-faith views of its affirmative obligations to avoid or minimise harm to civilians in military operations. As to the latter, as the ICRC’s most recent comprehensive report on IHL and armed conflict, though not addressing particular conflicts, explains that “states’ adoption of expedient interpretations of IHL […] to preserve States’ leeway to kill and detain […] have compounded to undermine its protective force.”   Whatever the case, each brings mass death and destruction and has a corrosive effect on compliance with laws designed to protect people already suffering from war. There must be accountability for both or else the tenuous power of IHL globally will further erode. The question is not whether the Geneva Conventions are relevant – they are – but whether they will continue to be either ignored or suffer death by a thousand cuts.   * Leonard Rubenstein is Distinguished Professor of the Practice at the Johns Hopkins Bloomberg School of Public Health. He chairs the Safeguarding Health in Conflict Coalition and is a former President of Physicians for Human Rights.   May 2024   International community must end impunity for violence against Healthcare in Conflict, says Safeguarding Health in Conflict Coalition   Governments and international agencies must do more to end impunity for violence against healthcare, campaigners have urged, as a new report shows that attacks on healthcare during conflicts reached a new high in 2023.   The report from the Safeguarding Health in Conflict Coalition (SHCC), an umbrella organisation of health and human rights groups, documented 2,562 incidents of violence against or obstruction of health care in conflicts across 30 countries—over 500 more than in 2022.   The group pointed out that the 25 percent rise on the previous year came as tens of millions of people in conflict-affected countries were already suffering from war, massive displacement, and staggering deprivation of food and other basic needs.   But beyond the inevitable suffering such violence against healthcare causes, the report’s authors highlighted that one consistent feature of the attacks was the continued impunity for those perpetrating them.   They say that despite repeated commitments, governments have failed to reform their military practices, cease arms transfers to perpetrators, and bring those responsible for crimes to justice.   And they have now called on national leaders and heads of international bodies, including UN agencies, to take strong action to ensure violence against healthcare is ended.   “There has to be a change in how we ensure accountability for violations of international humanitarian law when the protection of health care and health workers is not respected because current mechanisms do not provide adequate protection. We need to ask some hard questions,” Christina Wille, Director of the Insecurity Insight humanitarian association, who helped produce the report, told IPS.   Attacks on healthcare have become a prominent feature of recent conflicts—the SHCC report states that the rise in attacks in 2023 was in part a product of intense and persistent violence against health care in the occupied Palestinian territories (oPt), Myanmar, Sudan, and Ukraine.   And human rights groups have increasingly drawn attention to the deliberate targeting of healthcare facilities and medical staff by attacking forces.   Hospitals and other medical facilities are designated as protected civilian objects under international humanitarian law and it is illegal to attack them or obstruct their provision of care. Ambulances also have the same status.   This designation does not apply if the hospital or facility is used by combatants for military purposes, but even then, an attacking force must give warning of its attack and allow for an evacuation of all civilians. But in many conflicts, forces seem to be increasingly ignoring this.   The SHCC report highlights that right from the start of two new wars in 2023, in Sudan and the conflict between Israel and Hamas, warring parties killed health workers, attacked facilities, and destroyed health care systems.   Meanwhile, attacks on health care in Myanmar and Ukraine continued unabated, in each case exceeding 1,000 since the start of the conflicts in 2021 and 2022, respectively, while in many other chronic conflicts, fighting forces continued to kidnap and kill health workers and loot health facilities.   At the same time, the report identified a disturbing new trend of combatants violently entering hospitals or occupying them as sites from which to conduct military operations, leading to injuries to and the deaths of patients and staff.   SHCC Chair Len Rubenstein said that in many conflicts, the conduct of combatants revealed “open contempt for their duty to protect civilians and health care under international humanitarian law (IHL)” and specifically highlighted how Israel, “while purporting to abide by IHL, promoted a view of its obligations that, if accepted, would undermine the fundamental protections that IHL puts in place for civilians and health care in war.”   “The report highlighted a lot of disturbing trends—there seemed to be no restraint on attacking hospitals right from the start of conflicts, we also saw for instance, a rise in hospitals being taken for military use, and it was also very disturbing to see children’s medical facilities being deliberately targeted,” he told IPS.   “These trends highlight the need for leadership [on increasing accountability]. Accountability for attacks on healthcare is not a silver bullet—accountability for murder does not stop all murders, for instance – but no consequences are a guarantee of further violations,” he added.   Christian de Vos, Director of Research and Investigations at Physicians for Human Rights (PHR), which is a member of the SHCC, suggested a lack of accountability for attacks on healthcare in previous conflicts had emboldened certain forces to do the same in new wars.   “This goes back to the historical evolution of attacks on healthcare and the consequences of impunity. The patterns of attacks on healthcare that Russian forces, together with the Syrian government, perpetrated in the Syria conflict have a lot of links to how Russia has fought its full-scale invasion of Ukraine,” he told IPS.   In its report, the SHCC has made a number of recommendations to help end attacks on healthcare and hold those behind them accountable.   These include UN and national authorities and the International Criminal Court (ICC) taking new measures to end impunity, strengthening prevention of conflicts, improving data collection on attacks at global and national levels, bolstering global, regional, and domestic leadership—especially through the WHO and UN—on protecting healthcare, and supporting and safeguarding health workers.   Some of these plans would also see a key role played by local actors, including NGOs and other groups active in healthcare and human rights.   SHCC admits, though, that some of these are likely to be hard to implement.   “Our recommendations are aspirational and we accept that their implementation could be difficult in the context of the inherent difficulties of conflicts, but there are some areas where we think definite change could be achieved,” said Wille.   She explained that developing capacity for local health programmes to be more security and acceptance conscious could be strengthened.   “There is a need for training for the healthcare sector on how to understand, approach, and manage security and risk in conflict. Such support should be given to those responsible for overseeing plans for healthcare provision in conflicts so that services continue to be provided but with as much safety as possible,” she said.   She added that governments could also make a real difference by pushing to ensure ‘deconfliction’—the process by which a health agency announces to all parties who they are, where they work and what they are doing, and how it can be recognized and which in return receive assurances that they will not be targeted is adhered to by all sides in a conflict.   “Such mechanisms exist, however, at the moment, far too often they are not respected or applied in several conflicts. Governments can insist on the implementation of de-confliction, and this would also be a great help,” she said.   However, if significant change is to be made in ensuring accountability for attacks on healthcare, experts agree that it can only be done with strong political commitment on the issue.   “We have seen over the years that there hasn’t been this commitment and what we need is a strong commitment that will go beyond just words and statements condemning these attacks to real concrete action,” Rubenstein said.   He stressed that the massive, targeted destruction of healthcare seen in some recent conflicts had changed the wider political perception of the effects of such attacks.   “What has changed is the knowledge of the magnitude of these attacks and the enormous suffering they bring, not just directly at the time of the attacks but long after as well. This knowledge can stimulate the kind of leadership we need on this,” he said.   De Vos said that especially the Israel-Hamas war and the prominence of attacks on healthcare in that conflict had “shown clearly the devastation and suffering such attacks cause.”   “This might bring about the change in will to ensure accountability that we would like to see,” he said.   But while there may be optimism among experts around the chance for such change, they are less positive about the prospects for any reduction in the volume of attacks on healthcare in the immediate future.   “Unfortunately, the trajectory is not a positive one—there’s no ceasefire in Gaza, the war continues in Ukraine, and conflict is ongoing in the places where we have seen the most of these attacks on healthcare. It’s a pretty grim state,” said De Vos.   http://reliefweb.int/report/world/epidemic-violence-violence-against-health-care-conflict-2024 http://www.ipsnews.net/2025/05/health-workers-in-conflict-zones-experience-epidemic-of-violence/ http://www.ipsnews.net/2024/05/international-community-urged-to-end-impunity-for-violence-against-healthcare-in-conflicts/ http://www.alternatives-humanitaires.org/en/2024/11/27/threats-to-international-humanitarian-law-in-ukraine-and-gaza/ http://safeguarding-health.com/news/ http://www.ohchr.org/en/statements-and-speeches/2025/01/israels-attacks-have-devastating-impact-gazas-hospitals-turk-tells http://www.ohchr.org/en/media-centre/news-situation-occupied-palestinian-territory-israel-and-lebanon http://ukraine.ohchr.org/en/mediacenter/latestnews   http://www.unocha.org/publications/report/haiti/humanitarian-coordinator-calls-end-attacks-medical-staff-and-facilities http://www.msf.org/haiti-msf-outraged-attack-ambulance-and-execution-patients http://www.msf.org/msf-condemns-rsf-violent-attack-bashair-teaching-hospital-south-khartoum http://www.msf.org/south-sudan-msf-suspends-medical-activities-yei-central-equatoria-state-following-attack-staff http://www.msf.org/attacks-medical-care http://www.ipsnews.net/2025/01/armed-drone-attacks-on-humanitarian-aid-puts-future-at-risk/ http://www.bmj.com/content/387/bmj.q2474 http://www.thelancet.com/journals/lancet/article/PIIS0140-6736(24)02421-8/abstract
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